scholarly journals Effects of ketamine and ketamine with midazolam on emergence agitation in children following sevoflurane anesthesia

2018 ◽  
Vol 4 (2) ◽  
pp. 57-65
Author(s):  
Achyut Sharma ◽  
Resham Bahadur Rana
Keyword(s):  
Controlled Trial ◽  
Pediatric Anesthesia ◽  
Sevoflurane Anesthesia ◽  
Emergence Agitation ◽  
Ophthalmic Surgery ◽  
Prospective Randomized Controlled Trial ◽  
Recovery Times ◽  
The Mean ◽  
The Cost ◽  
Mean Time

Background : Emergence agitation is a distressful phenomenon associated with inhalational agents such as Sevoflurane in short surgical procedures. Various drugs have been used in the past but some come at the cost of increased complications. We aim to study the effects of ketamine alone and ketamine with midazolam on emergence agitation and their effects on recovery and discharge times.Methods: We conducted a prospective randomized controlled trial among 94 patients aged two to ten years presenting for ophthalmic surgeries in which 45 patients were allocated to each group: group K (Ketamine) and group KM (Ketamine with Midazolam). Group K received Ketamine 0.3 mg/kg IV and Group KM received Ketamine 0.3 mg/kg IV and Midazolam 0.03 mg/kg IV. Intraoperatively heart rate and post-operatively emergence agitation, recovery times, discharge times were studied.Results: Demographic variables were comparable between the two groups. Median Pediatric Anesthesia Emergence Delirium (PAED) score of 6 with IQR (4-6) in group K was comparable to the median score of 5 with IQR (4-6) in group KM. The mean recovery time of 22}4.82 min in group K was significantly lower compared to the mean time of 25.75}3.32 min in group KM. Mean time to discharge of 67}11 min from the hospital in group K was significantly shorter compared to that in group KM (108}18 mins).Conclusion: We concluded from our study that ketamine alone is as effective as ketamine with midazolam in reducing the emergence agitation following Sevoflurane anesthesia for ophthalmic surgery. Journal of Society of Anesthesiologists of NepalVol. 4, No. 2, 2017, page: 57-65

Modifield Desarda Repair and Hernioplastia Lichtenstein Repair for Inguinal Hernia

2021 ◽  
Vol 2 (3) ◽  
pp. 01-05
Author(s):  
Pedro Rolando Lòpez Rodrìguez ◽  
Eduardo Garcia Castillo ◽  
Olga Caridad Leòn Gonzàlez ◽  
Jorge Agustin Satorre Rocha ◽  
Luis Marrero Quiala ◽  
...  
Keyword(s):  
Inguinal Hernia ◽  
Operative Time ◽  
Controlled Trial ◽  
Operation Time ◽  
Lichtenstein Repair ◽  
Prospective Randomized Controlled Trial ◽  
The Mean ◽  
Group 2 ◽  
Location Type ◽  
Mean Time

Introduction: The objective of this study is to compare the outcomes of Modified Desarda repair no mesh and Lichtenstein repair for inguinal hernia. Methods: This is a prospective randomized controlled trial study of 1342 patients having 1394 hernias operated from January 2008 to December 2020. 690 patients were operated using Lichtenstein repair and 652 using Desarda repair. The demographie data (Age,Sex) , hernia type and location , anesthetic , operative time , postoperative pain and complications were analysed. Results: There were no significant differences regarding age, sex, location, type of hernia, and pain in both the groups. The operation time was 52 minutes in Modified Desarda group and 42 minutes in the Lichtenstein group that is significant (p<0.05). The recurrence was 0.0 % in Modified Desarda group and 0.28 % in Lichtenstein group. But, there were 9 cases of infection to the polypropylene mesh in the Lichtenstein group, 2 of this required re-exploration. The morbidity was also significantly more in Lichtenstein group (7,6 %) as compared to Modified Desarda group (3.8 %). The mean time to return to work in the Modified Desarda group was 8.26 days while a mean of 12.58 days was in the Lichtenstein group. The mean hospital stay was 29 hrs. in Modified Desarda group while it was 49 hours in the Lichtenstein group in those patients who were hospitalized. Conclusions: The modified Desarda repair scores significantly on Lichtenstein repair in most of all aspects, including reexplorations and morbidity. Modified Desarda repair is a better option compared to Lichtenstein repair.

scholarly journals Comparison of the Effects of 0.03 and 0.05 mg/kg Midazolam with Placebo on Prevention of Emergence Agitation in Children Having Strabismus Surgery

2014 ◽  
Vol 120 (6) ◽  
pp. 1354-1361 ◽  
Author(s):  
Eun Jung Cho ◽  
Seung Zhoo Yoon ◽  
Jang Eun Cho ◽  
Hye Won Lee
Keyword(s):  
Intravenous Administration ◽  
Controlled Trial ◽  
Pediatric Anesthesia ◽  
Strabismus Surgery ◽  
Secondary Outcome ◽  
Sevoflurane Anesthesia ◽  
Emergence Agitation ◽  
Emergence Time ◽  
Double Blind ◽  
To Receive

Abstract Background: Midazolam has been widely studied for preventing emergence agitation. The authors previously reported that in children with sevoflurane anesthesia, intravenous administration of midazolam (0.05 mg/kg) before the end of surgery reduced the incidence of emergence agitation but prolonged the emergence time. This study was designed to test the hypothesis that a lower midazolam dose could suppress emergence agitation with minimal disturbance of the emergence time in children with sevoflurane anesthesia. Methods: In this randomized, double-blind, placebo-controlled trial, 90 children (1 to 13 yr of age) having strabismus surgery were randomized to 1:1:1 to receive 0.03 mg/kg of midazolam, 0.05 mg/kg of midazolam, or saline just before the end of surgery. The primary outcome, the incidence of emergence agitation, was evaluated by using the pediatric anesthesia emergence delirium scale and the four-point agitation scale. The secondary outcome was time to emergence, defined as the time from sevoflurane discontinuation to the time to extubation. Results: The incidence of emergence agitation was lower in patients given 0.03 mg/kg of midazolam (5 of 30, 16.7%) and patients given 0.05 mg/kg of midazolam (5 of 30, 16.7%) compared with that in patients given saline (13/of 30, 43.3%; P = 0.036 each). The emergence time was longer in patients given 0.05 mg/kg of midazolam (17.1 ± 3.4 min, mean ± SD) compared with that in patients given 0.03 mg/kg of midazolam (14.1 ± 3.6 min; P = 0.0009) or saline (12.8 ± 4.1 min; P = 0.0003). Conclusion: Intravenous administration of 0.03 mg/kg of midazolam just before the end of surgery reduces emergence agitation without delaying the emergence time in children having strabismus surgery with sevoflurane anesthesia. (Anesthesiology 2014; 120:1354-61)

scholarly journals Laparoscopic versus open appendectomy retrospective study

2017 ◽  
Vol 4 (3) ◽  
pp. 620
Author(s):  
Haitham S. Rbihat ◽  
Khaled M. Mestareehy ◽  
Mohammad S. Al lababdeh ◽  
Talal M. Jalabneh ◽  
Mohammad E. Aljboor ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Postoperative Pain ◽  
Laparoscopic Appendectomy ◽  
Open Appendectomy ◽  
Advantages And Disadvantages ◽  
Abdominal Abscesses ◽  
Zero Rate ◽  
The Mean ◽  
The Cost ◽  
Mean Time

Background: Laparoscopic cholecystectomy is taken into account as a standard method of performing cholecystectomy and has substituted the old method throughout the world, while laparoscopic appendectomy still not attaining that reputation. In this paper, a retrospective study was done to compare between both laparoscopic and open appendectomy.Methods: Two hundred eighty-five patients were analyzed after appendectomy using either open or laparoscopic procedures. The data was compared over a period of 36 months. Surgical technique was the same among 6 surgeons, standard postoperative care for all patient groups. The outcome measures included comparing of mean operative time, days of hospitalization, postoperative pain and rate of wound infection.Results: Concerning open appendectomy the mean time was 28 minutes with 2 days of hospitalization. The postoperative pain extent was for 36 hours and rate of wound infection was 8/159. While in laparoscopic appendectomy the mean time was 55 minutes with one day hospitalization. The postoperative pain was for 12 hours and zero rate of wound infection.Conclusions: In general laparoscopy has plenty of gains over open surgery as discussed before but laparoscopic appendectomy is not easier, nor does it avoid general anesthesia. The cost for laparoscopic appendectomy is higher than for open appendectomy. The operative and post-operative complications are more critical (e.g.: intra-abdominal abscesses & perforation of bowel) as compared to open appendectomy. We have to assess the advantages and disadvantages, indications and contraindications when taking a decision for laparoscopic surgery. We suppose it would be very early to say that laparoscopic appendectomy is superior or can replace open appendectomy.

scholarly journals Comparison of time taken to obtain an arterial blood gas result at the bedside using the ProximaTM point of care machine vs. a standard remote arterial blood gas analyser: A randomized controlled trial

2020 ◽  
pp. 175114372097384
Author(s):  
Kay Mitchell ◽  
Karen E Salmon ◽  
David Egbosimba ◽  
Gavin Troughton ◽  
Mike PW Grocott
Keyword(s):  
Point Of Care ◽  
Controlled Trial ◽  
Blood Gas ◽  
Sampling System ◽  
Arterial Blood Gas ◽  
Arterial Blood ◽  
The Mean ◽  
Time Away ◽  
Mean Time ◽  
Reduced Time

Introduction The ProximaTM point of care (POC) device enables arterial blood gas (ABG) samples to be analysed without the nurse leaving the patient. The benefits of this for work efficiency have not been evaluated. Methods We compared the time taken to obtain an ABG result using ProximaTM versus a standard ABG sampling system. Twenty patients were randomized to ABG sampling using ProximaTM, or a standard ABG system. Nurses were observed performing all ABG sampling episodes for a minimum of 24 hours and no more than 72 hours. Results The mean time taken to obtain a result using ProximaTM was 4:56 (SD = 1:40) minutes compared to 6:31 (SD = 1:53) minutes for the standard ABG technique (p < 0.001). Mean time away from the patient's bedside was 3.07 (SD = 1:17) minutes using the standard system and 0 minutes using ProximaTM (p < 0.001). Conclusions Reduced time for blood gas sampling and avoidance of time away from patients may have significant patient safety and resource management implications, but the clinical and financial significance were not evaluated.

Comparison of the Efficacy of Transurethral Enucleation and Resection of the Prostate with Transurethral Resection of the Prostate for Medium Prostate Sizes

2020 ◽  
Vol 103 (11) ◽  
pp. 1208-1213
Keyword(s):  
Transurethral Resection ◽  
Controlled Trial ◽  
Length Of Hospital Stay ◽  
Average Weight ◽  
Intraoperative Bleeding ◽  
Tissue Removal ◽  
Prospective Randomized Controlled Trial ◽  
The Mean ◽  
Baseline Characteristics ◽  
One Year

Objective: To compare the efficacy of the transurethral enucleation of the prostate (TUERP) to transurethral resection of the prostate (TURP) through a prospective randomized controlled trial. Materials and Methods: Between January 2016 and December 2019, 46 patients from a single center were divided into two groups, TURP and TUERP, using simple randomization. The perioperative and postoperative outcomes up to one year after surgery were evaluated. Results: The mean estimated prostate volume (PV) in the TURP and TUERP group was 40±22 mL and 41±18 mL, respectively. There were no statistical differences in the baseline characteristics between the two groups. The mean operative time was significantly longer in the TUERP group (71.95±33.96 minutes versus 50.85±26.78 minutes; p=0.024). The average weight of prostate resected in the TUERP group was higher but not statistically significant (18.87±14.95 g versus 15.15±11.07 g; p=0.39). The volume of fluid irrigation collected postoperatively was significantly lower in the TUERP group (13.98±10.01 liter versus 24.73±21.90 liter; p=0.04). No statistically significant differences were noted between the two groups in terms of the postoperative IPSS, QoL, Q max, PSA, postoperative Hct, and the length of hospital stay. Conclusion: The present study compared the surgical outcomes between the TUERP and the TURP techniques performed in medium prostate sizes. The authors concluded that TUERP resulted in a greater prostate tissue removal and, importantly, better intraoperative bleeding control. Keywords: Benign Prostatic Hyperplasia, Transurethral enucleation of the prostate

A Prospective, Randomized, Controlled Trial of Forearm Versus Upper Arm Tourniquet Tolerance

2002 ◽  
Vol 27 (4) ◽  
pp. 359-360 ◽  
Author(s):  
A. C. MAURY ◽  
W. S. ROY
Keyword(s):  
Randomized Controlled Trial ◽  
Healthy Volunteers ◽  
Local Anaesthetic ◽  
Controlled Trial ◽  
Hand Surgery ◽  
Upper Arm ◽  
Tourniquet Time ◽  
Randomized Controlled ◽  
Prospective Randomized Controlled Trial ◽  
The Mean

This prospective, randomized, controlled trial studied the duration of upper and forearm tourniquet tolerance in 24 fit, healthy volunteers. Upper arm and forearm tourniquets were applied to either arm and inflated simultaneously. The time to request for deflation was recorded for each tourniquet. The mean tolerance for the upper arm tourniquet was 18 (range 10–26) min and for the forearm tourniquet was 25 (range 12–52) min. Under the conditions of this study, forearm tourniquets were tolerated for a mean of 7 min longer than upper arm tourniquets. The increase in tourniquet time afforded by a forearm tourniquet is clinically important in hand surgery performed under local anaesthetic.

scholarly journals Comparing the efficacy of 7%, 5% hypertonic saline and 0.9% normal saline in acute bronchiolitis: a randomized controlled trial

2018 ◽  
Vol 7 (5) ◽  
pp. 819
Author(s):  
Adel Ahadi ◽  
Manouchehr Barak ◽  
Fatemeh Amani
Keyword(s):  
Randomized Controlled Trial ◽  
Hypertonic Saline ◽  
Normal Saline ◽  
Clinical Symptoms ◽  
Controlled Trial ◽  
Study Groups ◽  
Acute Bronchiolitis ◽  
Randomized Controlled ◽  
Prospective Randomized Controlled Trial ◽  
The Mean

Background: The study aimed to investigate the effect of nebulized 5% and 7% Hypertonic Saline (HS) versus Normal Saline (NS) in acute viral bronchiolitis.Methods: This is a prospective, randomized controlled trial study that has been done on 90 infants presenting with acute bronchiolitis. All infants divided randomly in three equal size and matched groups (n=30). Subjects received 4ml nebulized 5% and 7% HS along with 0.15mg/kg Adrenaline or 4 ml 0.9%NS every 6 hours from enrolment until hospital discharge. For all patients, clinical symptoms such as sputum, wheezing, retraction rate, heart rate, fever, crackle, irritability, week nutrition and breathing were recorded in baseline and length of wheezing, cough, and crackle, length of stay (LOS), fever and sputum based on days in the end of study. Collected data analyzed by statistical methods in SPSS.19.Results: At baseline, study groups were similar in demographic and clinical characteristics. The mean age of all patients was 5.5±3.6 months, and 59 (65.6%) were male. The length of cough and crackle, and the length of LOS in 5% and 7% HS groups was significantly lower than NS group.Conclusions: Among infants admitted to the hospital with viral bronchiolitis, treatment with nebulized 5% HS and 7% HS had significant effect on decreasing clinical symptoms length and LOS when compared with NS.

scholarly journals Prophylactic premedication can reduce Emergence Agitation after Sevoflurane Anesthesia in Pediatrics: A placebo-controlled prospective trial.

2020 ◽  
Vol 24 (3) ◽  
Author(s):  
Amir Abouzkry ◽  
Sherif Arafa
Keyword(s):  
Prospective Trial ◽  
Pediatric Anesthesia ◽  
Anesthesia Care ◽  
Sevoflurane Anesthesia ◽  
Emergence Agitation ◽  
Web Based ◽  
Risk Of Injury ◽  
Children And Parents ◽  
Increased Risk ◽  
Inhaled Anesthetic

Sevoflurane is an inhaled anesthetic widely used for pediatric anesthesia, but emergence agitation (EA) or emergence delirium (ED) is a common sevoflurane anesthesia recovery-associated problem.1 Emergence agitation is associated with increased risk of injury in children and parents' dissatisfaction with anesthesia care.2 In a web-based survey of pediatric anesthesiologists in Canadian Pediatric Anesthesia Society, 42% felt that EA was a significant problem and 45% of them were giving medication before or during anesthesia to prevent its development.

scholarly journals Desarda repair no Mesh and Lichtenstein repair for inguinal hernia (A study of 2793 patients)

2021 ◽  
Vol 3 (9) ◽  
pp. 01-05
Author(s):  
Pedro Rolando Lòpez Rodrìguez ◽  
Eduardo Garcia Castillo ◽  
Olga Caridad Leòn Gonzàlez ◽  
Jorge Agustin Satorre Rocha ◽  
Luis Marrero Quiala ◽  
...  
Keyword(s):  
Inguinal Hernia ◽  
Hospital Stay ◽  
Controlled Trial ◽  
Operation Time ◽  
Lichtenstein Repair ◽  
Prospective Randomized Controlled Trial ◽  
Duration Of Surgery ◽  
The Mean ◽  
Location Type

Introduction: The objective of this study is to compare the outcomes of Desarda repair no mesh and Lichtenstein repair for inguinal hernia. Methods: This is a prospective randomized controlled trial study of 2793 patients having 2936 hernias operated from January 2002 to December 2020.1434 patients were operated using Lichtenstein repair and 1359 using Desarda repair. The variables like age, sex, location, type of hernia, tolerance to local anesthesia, duration of surgery, pain on the first, third and fifth day, hospital stay, complications, re-explorations, morbidity and time to return to normal activities were analyzed. Follow up period was from 1-10 years (median 6.5 years). Results: There were no significant differences regarding age, sex, location, type of hernia, and pain in both the groups. The operation time was 53 minutes in Desarda group and 43 minutes in the Lichtenstein group that is significant (p<0.05).The recurrence was 0.4 % in Desarda group and 0.4 % in Lichtenstein group. But, there were 14 cases of infection to the polypropylene mesh in the Lichtenstein group, 7 of this required re-exploration. The morbidity was also significantly more in Lichtenstein group (5,1 %) as compared to Desarda group (3.1 %). The mean time to return to work in the Desarda group was 8.26 days while a mean of 12.58 days was in the Lichtenstein group. The mean hospital stay was 29 hrs. In Desarda group while it was 49 hours in the Lichtenstein group in those patients who were hospitalized. Conclusions: Desarda repair scores significantly over the Lichtenstein repair in all respects including re-explorations and morbidity. Desarda repair is a better choice as compared with Lichtenstein repair.

Sign in / Sign up

Export Citation Format

Share Document